Update, Dec 1 2013

ljw120113


I started my treatments (simultaneous chemotherapy and radiation) in mid-October; I get chemo every Monday (it takes about 3 hours) and radiation five mornings a week (each session is about ten minutes long). The standard protocol for this kind of cancer is seven weeks’ therapy, which brings us to early/mid December.

 

 

Weeks One and Two were easy. I was able to work almost a full schedule, and felt almost no side effects at all. (I did notice that Thursdays were bad days for tiredness, malaise, etc.).

 

 

Week Three began to get interesting. One evening I discovered that my beard hairs were falling out by the dozens, so I shaved the whole thing off.  My sense of taste went wonky – almost everything tasted awful, like cigarette ashes and cardboard. Acidic and spicy foods were literally painful. Ice cream was okay for a while, and marshmallows, but I was eating less and less because the flavors and sensations were so unpleasant.

 

 

Week Four: now I was feeling it. I got very dehydrated (my own fault for not getting enough water). My old friend the kidney stone decided he wanted some attention too, so now I was taking pain medication both for my throat and my kidney. Swallowing was now becoming very painful too; I was reduced to eating soup and crackers, and I knew I was losing weight. Still going to work most days, but seldom for more than a few hours; I was generally very tired most of the time.

 

 

Weeks Five and Six: finally decided to stay home full-time and rest. Using my feeding tube now – frankly, much easier and efficient than I thought it would be. My daily menu is six cans of Ensure Plus, two each for breakfast, lunch, and dinner, plus lots of water.

 

 

On Friday of Week Five, I got very listless and warm; Partner took me to Miriam Hospital, where they determined that my white blood cell count had crashed over a period of a few days, and I had an opportunistic infection (probably thrush). I spent seven days there, absorbing intravenous antibiotics and waiting for my blood count to get back to normal. (The number in question, my Absolute Neutrophil Count, was around 300 when they checked me in; 1500+ is normal, and anything under 500 is dangerous.)

 

 

Anyway, so seven days in the hospital. I was perfectly comfortable, and all of the nurses and doctors were wonderful.  Partner spent time with me mornings and evenings. My voice is terrible – sometimes I can’t speak at all – which made communication with the nurses and nurses’ aides and doctors very interesting sometimes. (I ended up using a “conversation book” – if I wanted to say something more profound than “yes” or “no,” I wrote in my little red notebook and handed it to the person I was talking to.)

 

 

I was released on Friday, Nov 29 (ANC count 1000+), and am glad to be home. I’ve already resumed treatments; I have only eight radiation sessions to go, and one (or possibly two) chemo sessions. The completion date is still around December 11.

 

 

Good news: everyone agrees that the tumor and the accompanying lymph nodes are shrinking very rapidly. My neck is reddish and looks sunburnt, but everyone thinks the area looks very good. My throat’s painful, of course, and I generate mucus like an opened fire hydrant, but things could be worse. (The header picture was taken this morning a little after 3am. Notice that I have ditched the hospital pajamas. I think I look like Gale Gordon as Mister Mooney, getting ready to reprimand Mrs. Carmichael for something.)

 

 

Thanks to all for your kind thoughts and comments.

Sense of taste

sense of taste


One of the “minor” side effects of both radiation and chemotherapy is the loss of one’s sense of taste.

 

 

Well, not so much “loss.” More of a horrible transformation.

 

 

I had one of my favorite Japanese dishes recently: ahiru donburi, strips of grilled duck and bits of scallion scattered in a bowl of rice. Delicious! But a bit – hem – metallic.

 

 

Then wheat bread began to taste like cigarette ashes.

 

 

I tried a McDonald’s hamburger and fries recently. The fries were perfectly inedible, like pieces of uncooked leather. The burger tasted as if it had been marinated in Clorox.

 

 

Meat’s not good anymore, nor is bread.

 

 

What’s left? Chocolate pudding. Frozen yogurt. Lemonade. Soup. Rice Chex. Cheerios. Grape Nuts. Marshmallow Peeps! Mashed potatoes.

 

 

I told this to Apollonia, who was philosophical. “Take a lesson from Robocop,” she said. “Robocop ate a rudimentary paste.”

 

 

“A what?”

 

 

“A rudimentary paste,” she said carefully. “And now that’s what you’re going to have to eat too.”

 

 

“I wish I were Robocop right now,” I said. “I know what I’d do.”

 

 

“Calm yourself,” Apollonia said severely. “That’s the chemotherapy talking.”

 

 

So: anyone for some nice rudimentary paste?


 

The perfect homemade soft pretzel: the research continues

perfect homemade soft pretzel


The nice folks at King Arthur Flour, in their most recent catalog, posted a recipe for pretzel sandwich buns.  I made them, and they were very nice, but I thought: well, why sandwich buns? Why can’t I make nice soft pretzels at home?

I can, as it turns out.

But not a single batch has turned out perfectly yet. Some have a nice sourdough flavor, but lack consistency. Some are too bready. Some are too tough.

I’ve made at least four batches so far. They’re all good, but none has been perfect.

I’m still working on it.

Here’s the best version so far:

Combine –

  • 2 cups flour (white, or a mix of white and whole-wheat)
  • 1 tsp salt
  • 1 T instant dry yeast
  • 1 T butter
  • A scant cup of warm water
  • A pinch of sugar, or a scant teaspoon of honey

Mix, and knead for at least five minutes, using enough extra flour to make a nice smooth non-sticky dough. Put down in a greased bowl, covered with a dampened cloth, in a quiet place, for at least an hour (preferably more), until the dough has doubled. (A longer rise gives a yeastier flavor, which I like.)

Punch down the dough, divide into eight pieces, and roll each into a long rope about 15 inches long. Tie into a pretzel shape. Here’s a video to show you how:

(You can tie a double knot too. But practice a bit first.)

Place your eight pretzel children on a greased surface, cover with a dampened cloth for 15-30 minutes, and let them rest. While that’s going on, prepare for the end of the process as follows:

  • Preheat oven to 400 degrees.
  • Prepare a water bath: a saucepan with about a quart of water and about ¼ cup baking soda, heated to boiling.
  • Also break an egg into a large bowl and beat it.
  • Also line a baking sheet with parchment paper, or (second best) grease a baking sheet heavily.

Carefully drop your unbaked pretzels one or two at a time (depending on the size of your saucepan) into the boiling-water bath. Flip after 30 seconds or so. Take out of the boiling water after a minute.

Let the boiled pretzels rest for a few seconds. Give them a bath in the beaten egg (both sides), place them on the baking sheet, and dust them with coarse salt. (Coarse sea salt is inexpensive and easily available, at least locally.)

Bake for 15-20 minutes or until golden-brown.

Cool, and serve with butter or mustard. If there are any left the next day, reheat them in the microwave for (literally) ten seconds or so, and they’ll be almost like new.

Still not perfect, I know. Something’s missing.

But I’ll figure it out. I’ve got lots of time on my hands.


Lupini beans

lupini beans


Some time ago, Apollonia’s family was having a conversation about the actress Ida Lupino, and the (very demonstrable) fact that she made some pretty awful movies. Then Apollonia’s brother-in-law Rocky inserted: “What about lupini beans? Do you think Ida Lupino’s name has anything to do with lupini beans?”

 

 

And a fresh argument broke out.

 

 

See the picture above if you’re unfamiliar with lupini beans. They’re an Italian specialty, which you can probably find in your local supermarket (especially if there’s a big Italian community in your neighborhood). They’re not really beans, but the huge seeds of the yellow Mediterranean lupine. They contain a toxin, by the way. They have to be soaked and blanched and rinsed and salted and all kinds of things before they’re fit to eat. Then you still have to take off the husk before you eat them.

 

 

But they’re really pretty good, once you taste them. Also, they’re full of nutrients.

 

 

When Apollonia’s sister Augusta heard that I was ill, she rushed into action and sent me a jar of lupini beans, which she’d seasoned herself with olive oil and herbs. This was the accompanying note:

 

 

“My friend Ida always suggests a few lupini a day. They are loaded with fiber & protein – but don’t overdo it – too many can cause gastric lupinoma and gastric bezoar composed of multiple lupini beans. Surgical removal required. Enjoy!”

 

 

Also, she sent a can of air freshener, in case the outcome of the lupini beans was unfortunate (as it might be) for Partner and/or me.

 

 

I ate half a dozen of them, and I thought they were pretty good, and no air freshener was required. Partner is wary of them and hasn’t tried them yet.

 

 

Oh hell they’re just Mediteranean lupine seeds! What could they possibly do to you?

 

 

(I told Augusta, when I wrote her a thank-you note, that I hoped I did develop a gastric bezoar. You can use them as an antidote to poisons, and they also strengthen your aura.)

 

 

(You just wait. I will have a glorious aura.)


 

Barilla pasta, homophobia, and my recipe for faux Fettucine Alfredo

barilla


The CEO of Barilla Pasta, last week, made some very angry remarks about gay marriage, and said that he would never allow gay couples to appear in advertisements for his pasta. I paraphrase: “If people don’t like it, they can just buy another brand of pasta.”

Is he seriously out of his mind?

How many brands of pasta are there? I can think of six without stretching my brain too far. I generally buy what’s on sale, or what’s cheap, because – let’s face it – there’s not much difference. De Cecco is excellent (Mia Farrow and I agree on that); if I see it on sale, I buy it immediately, because it’s very certainly better than any other brand.

But is Barilla really better than Prince, or Bertolli, or Buitoni, or store brand, or Ronzoni, or anything else? Not really. Pasta is pasta, and I don’t need to buy pasta from a homophobe.

(Notes: the CEO of Barilla has sort of apologized, now that he’s realized how stupid he was. Also, other brands – like Buitoni and San Remo – have welcomed gay people to eat their pasta. Here’s a recent Buitoni advertisement:)

buitoni

Now: who wants fettucine Alfredo a la Futureworld?

–         Cook 1 lb pasta (preferably fettucine, but any other pasta will do, so long as it’s not anything made by Barilla) al dente. Drain.

–         While cooking the pasta, mix up the following:

  • ½ – ¾ cup ricotta cheese
  • ½ cup Parmesan cheese
  • 1 egg
  • 2 T prepared chopped garlic (sold in jars)
  • 2 T dried (or, better yet, fresh) parsley
  • Salt and pepper

–         Add ½ cheese mixture to empty saucepan over medium heat. Stir for a minute or two. Add pasta slowly, still stirring. Add remaining ½ cheese mixture. Taste, and correct salt / pepper / Parmesan / garlic.

–         Enjoy, with warm Italian bread and maybe a little extra Parmesan.

–         (And don’t buy Bertolli.)


Beets

beets


I hated vegetables when I was young. This included beans of all kinds, spinach, carrots, radishes, squash, peppers, tomatoes, and lettuce. Potatoes I accepted, because they didn’t look like vegetables; corn I also accepted, because it was sweet, and corn-on-the-cob was especially interesting (most especially when it was dripping with butter and covered with salt).

Some studies show that children are picky eaters because nature makes them that way; if we were living in a state of nature, foraging for our food, my pickiness might have saved my life many times over.

Also, pickiness is heritable from a parent. This makes sense to me: my mother was one of the pickiest eaters I’ve ever known, even as an adult. Her favorite meal was a hamburger and French fries at the local Burgerville (hold the ketchup).

But I’ve mostly gotten over my pickiness, as I’ve gotten older. I like trying new strange foods.

But I have not yet made friends completely with beets.

Beets are a root crop, and very healthy for you. Also, you can eat the greens on top.

But I am still not delighted with them.

When you prepare them with a little sugar and vinegar – that is, as “Harvard beets” – they’re almost nice. (The more vinegar and the sweeter the beets, the better.)

When prepared naturally, however, they have a very – um – natural flavor. That is to say, they taste like dirt.

Apollonia told me a story recently, about taking her sons to a local historical attraction, where people dress up in period garb and pretend that it’s 1790. A woman came up to them with a big bowl of beets. “Beets are wonderful,” the woman said. “You can pickle them, or eat them raw. You can eat them in salads. You can use them to dye cloth. Or –“

“Or,” Apollonia’s son said, “you can throw them out the window.”

This is an excellent suggestion. Next time I see beets on the plate, I will try throwing them out the window, and see what happens.


MUFAs

mufas


Do you not recognize the title of this blog? Well, I’ll tell you what it means: MonoUnsaturated Fatty Acids.

 

 

These are found in olives, and olive oil, and avocadoes, and nuts, and a few other places.

 

 

MUFAs are good for you. They defeat heart disease, and (some say) even cancer. They are very good for your cholesterol. They even help you control your weight.

 

 

MUFAs are the latest recruits in the nutrition wars. Remember “superfoods”? The list keeps growing. Recently, in the Providence Journal, they featured something called “seaberries” (also called “sea buckthorn,” Hippophae). They are said to have a “citrus-like” flavor that’s “somewhat unpleasant.”

 

But they’re good for you!

 

 

Remember goji berries? And acai? Also very unpleasant-tasting. I also find pomegranate juice unpleasant, unless it’s mixed with raspberry or something more palatable. All three of the above – goji, and acai, and unadulterated pomegranate – taste (to me) like dirt laced with motor oil.

 

 

But they’re good for you!

 

 

My student employee Joshua recently brought in a whole papaya, which he tried to eat. Papayas are a superfood, right? But his papaya (he told me later) was a little unripe: hard and sour. He ended up throwing much of it away.

 

 

But they’re good for you!

 

 

Here’s the thing about foods with MUFAs: we know them already, and they taste good. I like olives, and olive oil, and avocadoes, and cashews, and walnuts, and peanuts, and dark chocolate.

 

 

It’s like the old canard about American moms and French moms: “American moms tell their kids: ‘Eat it! It’s good for you!’ But French moms say: ‘Eat it! It’s good!’”

 

 

I’m with the French moms on this one.

 

 

Eat more MUFAs. They’re not just good for you; they’re good.


 

Eat more goat

eat more goat


I have eaten goat three times in my life (so far as I know).

The first time was in Morocco in 1984. I was visiting my friend Dave in Asilah, a lovely town on the northern Atlantic coast, and we decided impulsively to buy some goat meat and cook it.

We had no idea what we were up against. Goats (in Morocco at least) are tough. We cooked it for quite a while, but we still couldn’t eat it; the meat was wrapped around the bones like thick rubber bands. We gnawed on it for a while, but it was too tough for us. I think we threw it out and ate in a restaurant that evening.

The second time was here in Providence, maybe ten years ago. A work friend and I had heard about a good (and authentic) Mexican place on the West Side. Okay. Well, what do you order: something you could make at home, or something interesting?

They had goat on the menu. So I ordered the goat.

It wasn’t bad. It wasn’t wonderful, but it wasn’t bad.

The third time was just a few weeks ago. My student employee Joshua invited me to lunch at the Jamaican place across the street. They had “curry goat” on the menu. Well, once again: why not order something interesting?

“Curry goat” was delicious, and very tender. There were bits of gristle in it, and odd pieces of bone, but I think (when you’re eating goat) those are the rules of the game. Also, it came with fried plantains, and rice-and-beans, Caribbean style.

I’d order it again.

But oh my God: think of the poor little goat who died for this!


Microbes, probiotics, and prebiotics

prebiotics


Some time ago, Michael Pollan had an article in the New York Times Magazine about the cohabitation of microbes and human beings. It turns out that each one of us is a huge colony of cells, some of them specifically human, but the majority foreign to us. We contain more single-celled microbes than human cells, believe it or not.

But we coexist with those microbes. They live in us, and on us, and have done so for a very long time, and we have found ways of coexisting that are beneficial to all. Some microbes help to regulate our digestion; others regulate our immune systems; and so on.

Example: Helicobacter pylori. H. pylori was discovered several decades ago to be the main cause of stomach ulcers. Before this discovery, ulcers were one of those things you just suffered with, like arthritis. After the discovery, a quick course of specific antibiotics cured ulcers double-quick.

Except that it turns out that it’s more complicated than that. H. pylori helps regulate stomach acid when we’re younger; when we’re older, it causes ulcers. This (Pollan speculates) may be on purpose: maybe the body and the bacteria are collaborating to kill us, to move us off the stage so that younger and stronger people can take over.

 

 

H. pylori has been largely eradicated now. Is this a good thing? Perhaps. Perhaps not.

Pollan also takes on the issue of probiotics. Can we tend our gut flora as if it were a kitchen garden? Perhaps. We already do it with yogurt, and pickles, and sauerkraut, and all kinds of things. But now you can buy foods with “beneficial” microbes, which will colonize your stomach and intestines and make you unbelievably healthy.

Then there are “prebiotics.” These are foods that serve as quick-start fuel for microbial populations.

I tried one of these a few years ago.

Evidently I have a very lively microbial population in my gut. Giving it a little extra food was like giving Hitler the A-bomb.

I will never eat anything labeled “prebiotic” again.

I love my internal microbial population, but I don’t want them to take over completely.


For Ramadan: Harira

ramadan


Ramadan began last week. I have some Muslim friends on Facebook, so I see lots of “Ramadan kareem!” messages going back and forth.

 

 

The Islamic months don’t correspond to the seasons as ours do; their year is roughly 354 days long, so Ramadan happens roughly twelve days earlier every year. In 1984, my first year in Morocco, the first day of Ramadan was roughly the first of June. (There was some trouble that year. It’s not officially a new month until the new moon is sighted in Mecca, and the weather was bad that year in Saudi Arabia. Finally, around the third or fourth of June 1984, Ramadan was declared to be officially begun, almost by default.)

 

 

Summer is a bad time for Ramadan, and June is the worst of all, because June days are the longest days of the year. Muslims are enjoined to fast from the time in the morning when it’s light enough “to distinguish a black thread from a white thread” to the prayer-call at sunset. “Fasting,” in this sense, means no eating, no drinking water (very devout Muslims won’t swallow when they’re brushing their teeth, and there’s a lot of spitting in the street going on, because swallowing your own spit might qualify as drinking), no sex, no smoking (tragic in a culture like North Africa where everyone smokes).

 

 

That first year, in 1984, I tried to fast. I couldn’t do it. I realized, after two or three days, that no one could see me eating during the day if I just closed the window blinds.

 

 

Later, in Tunisia, I was more casual. I knew I was a “kouffar” (unbeliever), and so did everyone else, so I closeted myself in my office and smoked and drank water and coffee to my heart’s content. One of my Tunisian coworkers, who’d studied extensively in Europe and who was very worldly, joined me.

 

 

Then, a day or two later, someone else joined us.

 

 

After about two weeks, the whole office was smoking with me, on and off. It was okay, because they were with an unbeliever, and I was exerting an undue irreligious influence on them.

 

 

Ah, kids, those were the days.

 

 

There was a restaurant in Tunis not far from our house, which was also not far from the az-Zeituna mosque, one of the most famous mosques in Tunisia. During Ramadan, about fifteen minutes before sunset, we’d go there. They’d seat us and serve us soup.

 

 

But no one ate.

 

 

We waited for the boy at the mosque to give us the signal that the evening call to prayer was complete.

 

 

Then, in unison, we all dipped our spoons into our delicious thick chicken / tomato / chickpea soup, and broke our fast.

 

 

Here’s a recipe for harira, the traditional Ramadan fast-breaking soup:

 

 

Harira

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Makes about 12 cups

  • 1 whole chicken breast, halved
  • 4 cups chicken broth
  • 4 cups water
  • a 28-to 32-ounce can whole tomatoes, drained and puréed coarse
  • 1/4 teaspoon crumbled saffron threads
  • 2 medium onions, chopped fine
  • 19-ounce can of chick-peas, rinsed
  • 1/2 cup raw long-grain rice
  • 1/2 cup lentils
  • 3/4 cup finely chopped fresh coriander
  • 3/4 cup finely chopped fresh parsley leaves
  • dried chick-peas, picked over water

 

In a heavy kettle (at least 5 quarts) simmer chicken in broth and water 17 to 20 minutes, or until chicken is just cooked through, and transfer chicken with a slotted spoon to a cutting board. Add to kettle tomatoes, saffron, onions, chick-peas, rice, and lentils and simmer, covered, 30 minutes, or until lentils are tender. Shred chicken, discarding skin and bones, and stir into soup with salt and pepper to taste. Soup may be prepared 4 days ahead (cool uncovered before chilling covered).

 

 

 

I find this recipe incomplete. It needs ras al-hanout, the traditional North African seasoning (you can buy it online, or make it yourself from regular ol’ supermarket seasonings), and some eggs (Ramadan harira usually has pieces of hard-boiled egg in it).

 

 

Also: if you make this soup, serve it with lots of Italian or French bread, for scooping and dipping.

 

 

And if you don’t feel like cooking soup the long way, especially during this long dismally hot summer, I’ve discovered that Campbell’s makes some very nice soups in plastic bags, which are pretty authentic. Their “Moroccan Chicken with Chickpeas” is a very passable Moroccan shorba, verging on harira.

 

 

Pinch a penny and spend a couple of bucks and buy a packet of it, and enjoy it.

 

 

With some Italian bread, and a lemon wedge to squeeze into it.

 

 

Ramadan kareem.


 

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